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肱踝脉搏波传导速度、踝臂指数、动态动脉僵硬度指数与冠心病左心室舒张的关系

Correlations of brachial-ankle pulse wave conduction velocity, ankle-brachial index and dynamic arterial stiffness index with left ventricular diastole in coronary heart disease

    摘要
  • 摘要:
    目的 探讨老年冠心病患者肱踝脉搏波传导速度(baPWV)、踝臂指数(ABI)和动态动脉僵硬度指数(AASI)与左心室舒张功能的相关性。
    方法 回顾性分析87例老年冠心病患者的临床资料，将其设为研究组，另选取50例同期冠状动脉造影正常的老年人设为对照组。将87例患者根据是否存在左心室舒张功能不全分为A组47例和B组40例，并根据是否存在高血压分为C组41例和D组46例。比较各组baPWV、ABI、AASI水平差异，采用Pearson相关分析法分析baPWV、ABI、AASI与左心室舒张功能的关系。绘制受试者工作特征(ROC)曲线，分析baPWV、ABI、AASI对左心室舒张功能不全的诊断价值。
    结果 研究组baPWV、AASI水平高于对照组, ABI水平低于对照组，差异有统计学意义(P < 0.05); A组baPWV、AASI水平高于B组, ABI水平低于B组，差异有统计学意义(P < 0.05); C组baPWV、ABI、AAS水平与D组比较，差异无统计学意义(P>0.05)。Pearson相关分析显示，左心室舒张功能与baPWV、AASI呈负相关(r=-0.835、-0.381, P < 0.05), 与ABI呈正相关(r=0.617, P < 0.05); ROC曲线显示, baPWV、ABI、AASI诊断左心室舒张功能不全的曲线下面积分别为0.983、0.861、0.711, 灵敏度为95.7%、87.2%、44.7%, 特异度为97.5%、77.5%、100.0%。
    结论 老年冠心病患者表现为baPWV、AASI水平上升与ABI下降，且左心室舒张功能不全者表现更明显。baPWV、ABI、AASI均与左心室舒张功能显著相关，能够有效预测老年冠心病患者的左心室功能。

     

    Abstract:
    Objective To investigate the correlations of brachial-ankle pulse wave velocity (baPWV), ankle brachial index (ABI), dynamic arterial stiffness index (AASI) with left ventricular diastolic function in elderly patients with coronary heart disease.
    Methods The clinical data of 87 elderly patients with coronary heart disease were analyzed retrospectively, and were selected as study group, and 50 elderly patients with coronary angiography were selected as control group. A total of 87 patients were divided into group A(47 cases) and group B(40 cases) according to whether they had left ventricular diastolic dysfunction, and they were divided into group C (41 cases) and group D (46 cases) according to the presence of hypertension. The difference of baPWV, ABI, AASI indicators in different groups of patients were compared. Pearson correlation analysis was used to analyze the relationships of baPWV, ABI, AASI indicators with left ventricular diastolic function. The receiver operator characteristic (ROC) curve was used to analyze the diagnostic value of baPWV, ABI, AASI for left ventricular diastolic dysfunction.
    Results The levels of baPWV and AASI in the study group were significantly higher than those in the control group, and the level of ABI was significantly lower than those in the control group(P < 0.05); the level of baPWV and AASI in group A was significantly higher than that in group B, and the level of ABI was significantly lower than that in group B(P < 0.05). The baPWV, ABI and AASI in group C showed no difference compared with group D (P>0.05). Pearson correlation analysis showed that left ventricular diastolic function was negatively correlated with baPWV and AASI (r=-0.835, r=-0.381, P < 0.05), and positively correlated with ABI (r=0.617, P < 0.05). ROC curve showed that the area under the cerve of baPWV, ABI and AASI in diagnosing left ventricular diastolic dysfunction was 0.983, 0.861 and 0.711, respectively, with sensitivity of 95.7%, 87.2% and 44.7%, specificity of 97.5%, 77.5% and 100.0%.
    Conclusion The elderly patients with coronary heart disease show increased levels of baPWV and AASI and decreased ABI, and are more obvious in left ventricular diastolic dysfunction. The baPWV, ABI and AASI are correlated with left ventricular diastolic function, which can effectively predict left ventricular function in elderly patients with coronary heart disease.

     

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